The Power of Paying Attention
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The Power of Paying Attention

What Jon Kabat Zinn Has Against "Spirituality"

by Richard Simon and Mary Sykes Wylie

In 1966, Jon Kabat-Zinn, a graduate student in molecular biology at the Massachusetts Institute of Technology, was walking down one of MIT's endless, pallid-green corridors when he spotted a flyer advertising a talk about Zen by somebody named Philip Kapleau. A former reporter at the Nuremburg War Crimes Tribunal, Kapleau had spent years practicing Zen in Japan, and was about to publish a book, The Three Pillars of Zen, that would become a classic text for American students of Buddhism. Kabat-Zinn was a very bright, hard-driving, 22-year-old kid from New York City, the son of a distinguished research immunologist, who was just starting out on his own promising scientific career. He had no idea what Zen was or who Kapleau was, but, in a sea of notices posted on one of the huge bulletin boards lining the corridor, this flyer somehow called out to him.

There were only five or six others at the talk, Kabat-Zinn writes in his new book, Coming to Our Senses. He doesn't remember much about what Kapleau said, except that conditions in a traditional Zen monastery sounded basic to a fault--primitive, no central heat, and freezing cold in winter. But Kapleau explained that within six months of moving into the monastery, his chronic ulcers went away, never to return. Kabat-Zinn was startled to hear that ulcers--a physical ailment--could clear up without medical treatment. This fact seems to have sparked in him some barely-conscious surmise about the mind's power to affect the body that would later form the nucleus of his own vocation.

More important to Kabat-Zinn at the time, however, was something he remembers about the way Kapleau himself demonstrated the power of paying attention as if it really matters . This orientation to being in the moment, embodied by Kapleau and at the heart of the ancient Buddhist practice of mindfulness meditation, sounds pretty mild today--taught as part of meditation and yoga classes in every "Y" in America--but it was radical stuff in 1966. It apparently evoked in Kabat-Zinn a deep curiosity about the possibility that simply being fully aware of each moment as it happens could subtly but profoundly transform the entire quality of life. As he began his own daily practice, Kabat-Zinn started to discover for himself how meditation can take you deeply into the living, pulsing heart of reality, the bodily, down-home feel of your minute-by-minute, second-by-second existence.

Today, nearly 40 years after that portentous afternoon talk, Kabat-Zinn is acknowledged as one of the pioneers in mind-body medicine--a field that integrates ancient spiritual traditions like yoga and meditation with mainstream medical practice. In 1979, Kabat-Zinn established the Stress Reduction Clinic at the University of Massachusetts Medical Center, the first center in the country to use meditation and yoga with patients suffering from intractable pain and chronic illness. Since then, the clinic--now housed in the Center for Mindfulness in Medicine, Health Care and Society (CFM) in the Department of Medicine--has treated about 16,000 patients and trained about 5,000 medical professionals, 30 to 40 percent of them M.D.s. More than 250 similar programs have been set up at other major medical institutions around the country. At least 1,000 research studies on mindfulness-based stress reduction (MBSR) are in print in peer-reviewed journals, showing it can reduce chronic pain, high blood pressure, serum cholesterol levels, and blood cortisol, and alleviates depression, anxiety, post-traumatic stress disorder, and eating disorders. MBSR can also change the way emotions are regulated in the prefrontal cortex and alter the immune response to an influenza vaccine. In short, Kabat-Zinn has been instrumental in bringing a body of practices and beliefs, once the considered a fetish of spiritualized hippies, right into the mainstream of contemporary medical practice.

Finding A Calling

At the time of his first exposure to Zen, Kabat-Zinn was very much on the intellectual fast track and engrossed in the pursuit of scientific knowledge. Nevertheless, he was beginning to question the entire edifice of academic science and the hyperintellectual, highly abstract, amoral worldview it spawned. Like thousands of other students of the era, he was deeply embroiled in the movement opposing the Vietnam War then beginning to inflame campuses all over America. And, like them, he was becoming disenchanted with what the best scientists of his era were actually doing with their sharp intellects--creating the next generation of highly sophisticated and lethal weapons systems.

He was dismayed that the world's most brilliant scientists, many of whom were on his own campus, could be so sophisticated about science, yet so unsophisticated about the nature of the mind that produced the science. "We use all these fancy instruments, which are extensions of the senses--electron microscopes, radio telescopes, spectrophotometers--to study the world, but we haven't paid much attention to who's doing all this studying. Who's doing all this knowing? What's the mind of the scientist? We were, and are, smart in a lot of ways, but idiotic in a lot of other ways," he says.

By the time Kabat-Zinn finished his dissertation, he'd been studying Buddhism and yoga for about four years and knew that the standard life of an academic scientist wasn't for him. His academic advisors got a hint that his career trajectory might be a tad unorthodox when they saw that the first page after the title page of his Ph.D. thesis on molecular biology contained only the aphorism, "He who dies before he dies does not die when he dies." He spent about half the time allotted to the defense of his dissertation answering the committee's questions about what he meant by those 12 words, delivering an earnest and high-minded exposition on Buddhist thought in the process.

It was all very well to get hooked on Buddhism and mindfulness, but a young Ph.D. still has to go out and make a living. If, after years of studying with the world's biggest brainiacs, he didn't now want to take his appointed place among them, what, exactly, did he want to do? Kabat-Zinn would spend the next eight or so years trying to figure that out.

He taught science as a substitute junior-high-school teacher--occasionally teaching classes from a yoga headstand to keep his students' attention--then taught biology to nonscience majors at Brandeis, did research on anesthetics at Harvard Medical School, and, finally, secured a post-doc in cell biology and gross anatomy at the University of Massachusetts. Part of the reason he took the position was to apply what he learned dissecting cadavers to increase his yoga students' understanding of how yoga postures affected the inner structures of the body.

All these years, he focused on the question of what he was meant to do, what job--"with a capital 'J'"--he was supposed to have on this planet. He never felt that his training as a scientist had been a waste of time; on the contrary, he believed that, somehow, science would figure into whatever he ended up doing--but what might that be? He'd heard architect-visionary Buckminster Fuller say that the seeker after a vocation should ask him- or herself, "What can I do that isn't going to get done unless I do it, just because of who I am?" This question obsessed him, becoming the subtext of all his meditations, the koan he lived with for 10 years.

The answer finally began to come to him while he was working in the U Mass anatomy department, where he had the opportunity to talk to doctors and go on rounds with orthopedic surgeons. What did the surgeons do to help their patients deal with intractable pain that drugs didn't help, he wanted to know. Send them for physical therapy, was the answer, though it didn't usually work very well. Patients tended to passively accept physical therapy, the way patients generally accepted drugs or any other medical treatment, as something being done to them to make the pain go away. In difficult and longstanding cases, when these interventions didn't work, patients felt themselves progressively ground down by their chronic pain. And Kabat-Zinn soon found that most of the doctors, of whatever specialty, had patients they could no longer help, didn't know what to do with, and secretly hoped would just go away.

At about the same time that he was discovering this little-advertised fact about the limitations of high-tech medicine, Kabat-Zinn embarked on a two-week Vipasana meditation retreat getting up to practice in the cold at 3:00 a.m., suffering the all-consuming discomfort of sitting cross-legged and motionless for hours and days. One morning, an idea serendipitously struck him with all the force of a keisaku --the wooden stick used by Zen teachers to administer a bracing, but physically harmless, whack on the back to wake up sleepy or daydreaming sitters. As he recalls, "It was on the 10th day, or something like that, and after all of those years meditating on what my job on the planet was, I suddenly thought, 'Oh my God, I could bring all this stuff--meditation, mindfulness, yoga--into the hospital!'" In a sudden epiphany, Kabat-Zinn could see the entire plan unfolding in his head--how these techniques could be taught to chronic-pain patients in a hospital setting and to healthcare workers from other hospitals and clinics, who could teach them to their own patients. Mindfulness training wouldn't necessarily relieve pain, but it could transform the experience of pain, help people change their relationship to it and thus soothe their suffering, even when no drug or medical treatment made any real difference.

But would these peculiar ideas fly back at U Mass Medical? There was already a relatively small, but nicely growing, body of literature suggesting that meditation and yoga could influence physiology. Studies in the early '70s by Harvard medical professor Herbert Benson, for example, had shown that practicing Transcendental Meditation promoted physiological relaxation and lowered blood pressure. So, when Kabat-Zinn broached the idea of teaching meditation to pain patients, the head of the pain clinic, the assistant director of the orthopedics department, and the director of the primary-care clinic, all agreed to send in patients right away. Soon after Kabat-Zinn began his one-man, two-day-a-week program in an office borrowed from a physical therapist, the chief of medicine (royalty in the hierarchical world of the medical establishment) came down and asked him if he wanted to run the program through his department--a vote of confidence, if there ever was one! Kabat-Zinn soon began gathering together a pool of "interns"--anybody in the hospital who wanted to learn about this new thing--developing in the process a small core team to run the rapidly expanding program.

How was it that Kabat-Zinn was allowed to try a decidedly fringy approach on patients in the absence of any professional credentials in this line of work? Or as he puts it, "How the hell did somebody with no training in clinical medicine or psychology, no credentials, and no license, get to work with medical patients?" He was given carte blanche partly because he was passionate and articulate, and also because his Ph.D. in molecular biology from MIT with a Nobel Laureate dissertation advisor provided an entrÂ´ee in professional circles, even if it didn't have much bearing on his new job.

While the program was a "clinic," in name only when it began, today, it stands proudly housed in its own spacious quarters, with the full staff of directors, instructors, administrators, receptionists, and bureaucratic billing procedures of any self-respecting hospital department. Still, the basic content of the program has hardly deviated from what it was at the beginning. While patients are greeted with open-hearted kindness and authentic presence, they're also asked to commit themselves to full participation in the eight-week program--go to weekly classes, meditate for at least 45 minutes six days a week (using tapes provided), and attend a day-long, silent retreat in the sixth week.

The results patients experienced in the new clinic were almost immediate. One doctor told Kabat-Zinn, "You did more for my patient in eight weeks than I've been able to do in eight years." People with all kinds of medical and emotional conditions reported that they slept better, were more relaxed, and were less anxious. Persistent headaches went away, blood pressure dropped, and pain often decreased. What Kabat-Zinn had done for them was "astounding," they told him, "a miracle." To which, Kabat-Zinn, ever the stern empiricist, constitutionally allergic to both mysticism and hero worship, would reply, "Don't use that language. I didn't do anything for you. You did it yourself. All I did was arrange the conditions and give you enough support and encouragement and tools to do it."

The skills the clinic taught patients were hardly the stuff of science. Nonetheless, from the get go, science counted for Kabat-Zinn, who realized that if he wanted to have any impact on the world of medicine, his clinical cases would have to be backed up by solid research. So he quickly began learning how to do outcome studies in behavioral medicine. By 1983, he and his colleagues were publishing research papers and monographs on treatment outcomes related to chronic pain, anxiety, cancer, immune function, heart disease, and trauma. In a 1988 landmark study, he and Jeffrey Bernhard, chief of dermatology at the U Mass Medical Center, demonstrated that patients undergoing ultraviolet-light treatment for psoriasis--a chronic and unsightly skin disease--healed four times faster if they'd been meditating in the lightbox. The study powerfully suggested that, at least in some circumstances, the activity of the mind could speed healing of the body and save money in the bargain; in some cases, the meditating psoriasis patients needed many fewer treatments than did their nonmeditating cohorts. Meditation also reduced the incidence of skin cancer caused by the UV treatment.

A Well-Kept Secret

During the next decade, the clinic quietly went about its operations, attracting little fanfare in the wider world. As Kabat-Zinn recalls, "The work was a really well-kept secret. Nobody knew what we were doing, and no one cared. It was just fabulous--a kind of golden era, without all the challenges brought by notoriety or fame or whatever you want to call it." Then, in 1990, Kabat-Zinn published Full Catastrophe Living, a book describing the program at the Stress Reduction Clinic and his experience with the power of mindfulness training to help people cope with stress, pain (physical and emotional), and illness. With a preface by Buddhist monk Thich Nhat Hanh and plenty of testimonials from physicians and medical professors on the cover, the book blended ancient tradition, modern science, and Kabat-Zinn's own reassuringly commonsensical approach that appealed both to experienced students of meditation and people who'd never heard of it. It almost immediately began to attract a devoted readership, and has gone on to sell about a half-million copies.

HASH(0xc8dee0c) Full Catastrophe Living also caught the attention of celebrated television journalist Bill Moyers, who included Kabat-Zinn's Stress Reduction Clinic in his five-part PBS television series Healing and the Mind. The film crew shot about 54 hours of film for a 45-minute segment featuring the clinic, an improbably riveting piece of filmmaking, particularly considering that a great deal of the "action" consists of one chronic-pain patient silently meditating. "The film was its own guided meditation on television," says Kabat-Zinn, "and captured the feeling and tone in the room in a way that, I think, entrained the 40 million people who saw it to intuitively resonate with what they were seeing and feeling."

If the book made waves, the PBS special started a deluge. The hospital had to set up a special phone bank to deal with the onslaught of inquires about the clinic, which numbered well over a thousand calls in the month after the show. As many as 40 percent of the callers were doctors, many of whom said they didn't know what they'd seen, but whatever it was, they wanted it. Within six months, Kabat-Zinn and his staff set up a larger, more accessible training program for doctors and patients.

In 1994, Kabat-Zinn published Wherever You Go, There You Are, a kind of meditation on meditation, which has sold, to date, 800,000 copies. This January, his new book, Coming to Our Senses, about the power of mindfulness as a means to social change, will be published.

Although retired from his position as professor of medicine and executive director of the Center for Mindfulness in Medicine, Health Care and Society, Kabat-Zinn continues to be involved with his colleagues in pursuing a range of studies on the impact of mindfulness-based stress reduction on such conditions as prostate cancer, hypertension, asthma, fybromyalgia, chronic fatigue, and irritable bowel syndrome. They have also just completed, but not yet published, a paper on the impact of mindfulness training in Spanish and English on inner-city residents, and are writing a paper on a project looking at the practice of mindfulness in prisons.

In all of this blizzard of work and work in progress, one fact stands out: Kabat-Zinn is as much a scientist who also meditates, as he is a meditator who does science. In a world that prefers its distinctions to be clear-cut and mutually exclusive, he's someone who's successfully built bridges between different worlds and worldviews.

And a bridge-builder between wildly different ways of looking at the world inevitably embodies certain paradoxes. A student and practitioner of an ancient spiritual tradition, he's suspicious of the word spiritual, because he thinks it obscures and mystifies more than it reveals. In his view, while meditation may ground people in the fundamental reality of their being, in another sense, it's nothing special. In fact, practicing mindfulness may be the most democratic of skills. "Anybody can meditate," Kabat-Zinn says. "You don't have to be a college professor." And you don't have to be a Buddhist. Although many people assume that he's a Buddhist, he prefers to describe himself as a student of Buddhist meditation.

His entire career has been devoted to bringing this practice home, into the life of anybody who wants to find some peace of body and mind, some sense of clarity and calm, even in the midst of enormous challenges. "My interest has been to find a way to make mindfulness available to regular people, people who are suffering in one way or another, and who may benefit from mobilizing inner resources they may not even know they have."

In the following interview with Networker editor Rich Simon, Kabat-Zinn, who'll be a keynote speaker at the Networker Symposium in March, discusses the "science" of meditation, the nature of inner freedom, and the distinction between mindfulness and psychotherapy.

--Mary Sykes Wylie

Psychotherapy Networker: In Coming to Our Senses, you try to show the connection between the Eastern knowledge tradition of meditation and Western science. Could you start off by explaining what one has to do with the other?

Jon Kabat-Zinn: Western science, for the most part, has devoted itself to studying nature and what's observable in the outer world. Basically, meditation is about bringing the same kind of systematic discipline to understanding inner phenomena, and that, too, is a legitimate field of investigation for science. You could call it the science of subjectivity, of first-person experience, of interiority.

For example, my colleague and friend Richie Davidson is involved in inviting Tibetan monks who've devoted their entire lives to meditation practice into his laboratory of affective neuroscience at the University of Wisconsin to be studied by various means while they're meditating. What he's found is that these monks have an extraordinary ability to describe the inner terrain of subjective experience with reliability and objectivity. They can tell you exactly what's going on inside them when, for example, you're picking up changes in the fMRI scanner. When one of these monks says, "My mind is stable," you can actually see stability on the brain scan in that moment. And when the scan reads a shift activity associated with a particular meditation practice, they're able to reproduce the shift voluntarily in almost no time.

This isn't a question of having them meditate for an hour and then measuring the change in the brain pattern. They can shift into very different states and corresponding brain patterns every 90 seconds. By contrast, if you ask college students hooked up to the same equipment what they're experiencing in the mind, as a rule, they just don't know. They're not such reliable reporters on inner experience, and show much less coherence in their brain patterns or the ability to change them at will.

PN: In Coming to Our Senses, you also shoot down a number of what you consider to be popular misconceptions about meditation. What are these misconceptions?

K-Z: First of all, I wouldn't say "shoot down"--that's a little violent for my taste. But people do have a lot of misunderstandings about meditation. As it's become more popular in the West, it's also become loaded down with a lot of images, associations, and connotations that aren't necessarily useful. One common misunderstanding is that meditation is some kind of interior maneuver into a special state of relaxation, as if you're throwing a switch in the back of your mind and then you're in the "meditative state." But mindfulness is really about bringing awareness to virtually any situation or any circumstance or any mental state. It's not about staying in any one particular state. You practice it just to be awake.

Now we all have the capacity to be awake, but that wakefulness is usually so fleeting because we're so used to distracting ourselves or propelling ourselves or repelling ourselves that we normally don't do very much to feed that tiny little flame of recognition that awareness is.

PN: I remember years ago seeing Bill Moyers nonplussed on his PBS special when, after he asked you whether the purpose of meditation was to slow down the mind, you answered, "There is no purpose to meditation. As soon as you assign a purpose to meditation, you've just made it just another activity to get someplace or reach some goal." What did you mean?

K-Z: What I was emphasizing there was the nondoing element of meditation, getting away from the goal-oriented thinking that takes up so much of our lives. But, of course, in a larger sense, the purpose of meditation is really just to know yourself. In our everyday lives, we're not really aware of knowing as the fundamental organizing principle of who we are. So we're always trying to get stuff to complete ourselves, without recognizing that we may already be complete. And even if we need to work everyday to get food or problem-solve or handle the other stresses of being a human being, we can do that best by bringing the entirety of our being to bear on whatever we may be doing.

Most of us are usually out of touch with the present moment to some extent. We all create a certain kind of story about ourselves, and then proceed with our lives without realizing that, in doing that, we've removed ourselves from the actuality of living itself. We're so caught up in the story of "I," "me," and "mine" that we lose what's best and deepest in ourselves. That creates a huge amount of suffering and alienation. And, basically, meditation says that's unnecessary. The Buddha, who you could say was a great scientist of the mind, taught, based on studies in the laboratory of his own experience, that it's possible to liberate ourselves from many of the habits of mind that contribute to that suffering and alienation. Meditation offers us a chance to taste or feel or smell the actuality of our experience without all the stories we usually associate with it.

PN: But how do you live without a story? Are you saying that meditation is opposed to what modern neuroscience is telling us about the brain's apparent predisposition to organize our experience through story?

K-Z: What I'd say is that meditation enables us to reconstruct the stories we live by to make them more accurate and larger than they'd be otherwise. Of course, meditation doesn't give you different parents. Your mishigas (this is a technical Buddhist term) is going to be your mishigas the rest of your life. But meditation helps us to recognize that we're bigger than we think are. And it helps us to come to our senses, to wake up, to realize what's actually going on in the realm of experience.

Let's say we take the sense of our own breathing--because so many meditative traditions start with the breath for a variety of reasons. It's part of the body. It's close to home. You can't leave home without it. So you start to pay attention to the breath. You don't need to be "mystical" or "spiritual" to do that.

So, if you start to pay attention to something as simple as the breath, you all of a sudden notice some really dramatic and shocking things. You can do this as an empirical scientist. The first thing--never mind for the moment who's the "I" that's watching--but the first thing that happens is that "someone" notices that it doesn't take long for the mind to go off someplace else and lose the breath completely. Breath is still going in and out, but there's no awareness of the way it feels. That then gets noted because some corner of the awareness sooner or later remembers or detects, "Oh, wait a minute. I was supposed to be on my breath for these five minutes as if my life depended on it, and here I am emphasizing something or other or obsessing about this or that. What just happened?"

So then you notice what's on your mind, whatever it is. But instead of beating yourself up and saying, " I'm a bad meditator," the exercise would be more like, "That's interesting. I said I was just going to stay with the feeling tone of the breath, not thinking about breath, but just the sheer sensation of the belly rising and falling, or the feeling of the air passing by the nostrils, and five seconds don't go by and I'm off someplace else." Noted. Back to the breath. There you go again. Another five seconds go by. You're off someplace else. You rapidly come to realize this is a habit. "This is part of the way my mind is wired. Holy smoke. I can't even focus." Well, that, in itself, is very interesting data.

PN: Thus the "inner scientist."

K-Z: Yes. Life itself becomes your laboratory. This little experiment of observing your own breathing for five minutes can be quite revealing, and humbling. It's like, "Oh, I may think I'm free, but actually my mind is at the mercy of whatever crosses my field of vision, my hearing, or smelling, or whatever." There's nothing wrong with that. I'm not judging it. I'm just saying it's interesting to notice. It's not about good or bad.

So what we're saying is, for a moment, let's just see if we can be with our direct experience and not label it all. Just note it. Just see. The mind wanders. You bring it back. The mind wanders. You bring it back. The mind wanders. You bring it back. The mind wanders. You don't want to bring it back anymore. You're bored with it already! A minute has gone by. I get the idea. I'm not interested in meditation. Or, I'd rather be thinking whatever. I'm busy. And then something strikes you. "Holy smoke. This is kind of like the native space of my mind. When I want to bring it to something really important, say an emotional issue, relationships, work, or anything else, I'm bringing that same mind. It's like it has no capacity to get out of its own way or be more spacious, be more stable, more calm and open, or be less reactive and judgmental."

As I say, that's interesting. You know how long it takes for you to realize that? Less than five minutes, because in five minutes, the mind will wander an infinite number of times, or close to an infinite number of times, especially if you're living a busy life.

PN: At the same time that meditation has become so popular, I know so many therapists who insist that it does nothing for them. For whatever reason, they don't get what you're trying to describe here. How do you convey to people like that what meditation has to offer?

K-Z: Certainly, I hear from people all the time who say things like, "I just sat there and it was just nothing. Why would I waste my time doing that?" One of the best lines was from one of my patients at the clinic who said, "I might as well be ironing the couch."

Now I don't like to "sell" meditation or give people a sense of "Just meditate and these are the things that you'll feel." From my point of view, that's much too goal oriented. But I'd say that, at the most fundamental level, meditation can show you how to cultivate intimacy with your own body and be in what the Buddhists might call "right relationship" with it.

Many of us are just really encapsulated in our head and in thought, while our bodies are kind of on their own. Then when we experience pain or disease, we may realize that we're actually in an adversarial relationship with our own body. We may be obsessed or preoccupied with its appearance. Or when our body does something we don't like--like come down with disease--we want to drive it to the hospital and have it fixed, as if it were an automobile.

In our clinic, many people learn through meditation that the body is the fundamental ground of our relationship to the world, even if, most of the time, we're not paying attention to it. Through meditation, they learn to call on deep inner resources for healing that are biologically available to all of us.

I, Me, Mine

PN: What about how meditation shifts our experience of personal identity?

K-Z: Moment to moment, we're usually flitting around, living inside our heads. You might think about it this way: if you wanted to look at the moon, for instance, and you put your telescope on a waterbed, you wouldn't really have very much success focusing on, or even finding, the moon; your instrument of observation would first need to be stabilized. In the same way, if you want to understand something about the nature of your own life, then you have to learn to stabilize your mind.

But when you begin to meditate, you soon realize that your major instrument for understanding both your relationship with the outer world and your relationship with the inner world is so much more unstable and chaotic than you usually notice in everyday life. Pretty soon, you come up against this basic mystery that some people can spend a lifetime ignoring: who is this "I" who's doing all this experiencing? After all, if you ask biologists looking at how the 100 trillion cells in the body interface with each other, they'll probably tell you that it's an impersonal process--there's no "person" in there. Yet, somehow, out of this three pounds of meat we carry around inside our heads, we get the idea that there's an "I" involved in all this. Yet you can't find that "I" anywhere by looking at all those cellular interactions. It's an emergent phenomenon, so to speak, that comes out of the complexity of it all.

Maybe because it's all so complex, lots of people develop some reified notion of themselves and live their life based on some kind of diminished story of who they are. You can live a great deal of your life in delusion of one kind or another and miss altogether the larger mystery of being human. What meditation does is help us find a way to embrace our interconnections with the outer and inner worlds. It's what Whitman was talking about when he wrote, "I am large, I contain multitudes." Yet most of us feel small, and, if we contain multitudes, they're often at war with each other.

We're all out of a painting by Marc Chagall--figures floating in the air, twisting in this huge spaciousness that surrounds our lives. There's no solid, reified, absolute "me" that we can build a fort around. Meditation teaches us how to become at home in this groundless domain, like a fish in the water. We discover that we don't need to have the usual artificial props of our "identity" to ground us, when we realize that the ground actually is itself also floating.

PN: As you say this, I keep thinking of where we started this conversation and the connection between meditation and the scientist's drive to find order in the world.

K-Z: What I'd say about that is that meditation helps us find the relationship between the chaos and order that are both part of our lives. As we were saying earlier, the mind is chaotic: our focus keeps shifting, seemingly uncontrollably, from moment to moment. But inside of that chaos, at any and every level, you also find order. And then if you look inside that order, you find some other level of chaos. The interesting thing isn't to be too ordered--that's actually a state of stasis or death. But if the body gets too chaotic, you'll be in atrial fibrillation or a complete state of mania. Living systems are continually at the edge of chaos. That's why meditation can teach us the deepest lessons of what it means to be alive. It shows us how to surf the wave between the chaos and the order. Even when it's very, very turbulent, meditation helps us find the sweet stillness inside the wave. That's what I call being awake.

Ultimately, meditation teaches us that if you bring mindfulness to the present moment, you have more ways of seeing that are fresher, and you're less likely to be caught in conditioning. Then, of course, the next moment you'll get caught again. So that moment's already gone, and there's another one for you to experience. The question is always, "How am I going to be in right relationship, or wise relationship, to this moment at the level of the body, at the level of the mind, at the level of feelings, at the level of perception?" And it's all one piece: it's not fragmented. And that's why I say meditation isn't a technique that you deploy to get to some kind of special state. It's a way of being in your life that's embodied and awake, and without agenda. It's not about trying to get somewhere. I guess the way to put it is that you are where you are.

Therapy and Mindfullness

PN: As the man said, wherever you go, there you are.

K-Z: Exactly. Then your luggage is another story.

PN: What's the difference between the kind of mindfulness that you're describing and what therapists are trying to accomplish in their work?

K-Z: I know many therapists who are incredibly empathic with their patients and extremely good at listening and not being judgmental. They know how to make things spacious and cultivate calmness in the relationship, but they sometimes don't admit that they themselves haven't come close to dealing effectively with their own suffering. And their own therapy doesn't help all that much. Perhaps this is why many therapists are drawn to the interface between mindfulness and therapy as much for themselves as for their patients. In therapy, there's a huge amount of the compassion perspective, but the wisdom perspective--the ability to get beyond the psychological story of "me"--can be a long-term challenge, or even an obstacle.

PN: Can therapy provide anything that mindfulness doesn't?

K-Z: I think there is something that only good therapy provides: the opportunity for a relationship with someone who's honest and loving, yet recognizes the sovereignty of the individual other. That's a huge difference. In our clinic, we see 25, 30, 40 people at a time in our classes. We don't have the resources to spend hours a week talking with people about their personal issues, although we do to a degree, as required.

People who've been badly harmed may need that kind of attention at a much more in-depth level than we can provide; others may not. But the primary relationship in Mindfulness Based Stress Reduction is actually their relationship with themselves, not with us. That's why we start with the body and the breath. The challenge is, "Can I befriend myself?" In that sense, the therapeutic aspect of meditation doesn't start with the therapist: it starts with your relationship to your own experience. And if you hold that in a way that's benign and compassionate, some people might say you can serve as your own therapist, although putting it that way seems to pathologize something that's only a natural part of being human.

PN: From the viewpoint of mindfulness, what happens in the "relationship" that you're referring to? What is it exactly that the therapist offers the client?

K-Z: The therapist is trying to help the patient cultivate a kind of autonomy that's already here, that's at his or her core, even though the patient might not be able to experience it yet. Holding that kind of space for the other person is probably the most compassionate thing one human being can do for another. That's what I'd call love. But what's most important for therapists, in my view, is to approach what you do with real caring, and not just as a job to get done. That means truly recognizing that every single person is different, even though you've seen a million cases that may seem the same. That means experiencing each moment with them as unique--and that may mean reminding yourself, "This is a human being, who's always more than any small story she may be telling herself at any moment."

PN: What you're describing is what some therapists might call bringing a "spiritual awareness" into their work. But in your books, you seem to go to great lengths to avoid using the term spiritual.

K-Z: You're right. I almost never use it. In fact, in Wherever You Go, There You Are, the last chapter is called, "Is Mindfulness Spiritual?" There tends to be a lot of confused thinking about spirituality that comes perhaps out of a natural hunger we may have for some kind of transcendent experience. When I hear another person describe someone as "very spiritual," I often just find myself laughing inside. Who isn't "spiritual" when it comes right down to it?

Usually, it's just a projection. I prefer to use the term "fully human," rather than talk about "spirituality." For me, it's a way of speaking about waking up to what's deepest and best in all of us, and already here, if only sometimes in seed form, undeveloped.

K-Z: Not "there." There's no "there." We're talking about "here." What's happening right here is what it's all about. It's about realizing, with a hyphen-- real-izing --making real, what's actually already so. We're largely ignorant of those dimensions of our being that tend to be bigger than our thinking. As I ask in Wherever You Go, There You Are, is having a baby a spiritual experience? Is being a father a spiritual experience? Is chopping vegetables a spiritual experience? Is taking a crap a spiritual experience? If they're not, then what's a spiritual experience? Anything can be a spiritual experience. It depends on the quality of the being that's in the experiencing.

So if you're thinking, "Oh, now I'm having a spiritual experience. I can't wait to tell people about it," it's really just another way to show how accomplished you are--another advertisement for yourself, to yourself, more clinging without awareness to those knotty personal pronouns I, me, and mine. Acquiring new "spiritual experience" can be just another addition to one's CV, as opposed to actually becoming more aware of one's being and the obstacles to wisdom, compassion, and the ability to be balanced and helpful in the world. To me, it's utterly simple: the most spiritual people I've ever met don't look "spiritual." They're not trying to be spiritual. They're just who they are, whatever the costume.